Aqua aerobic and pulmonary diseases

Pulmonary diseases limit the body's ability to provide oxygen to the body's tissues. They generally fall into two categories: chronic obstructive pulmonary disease (COPD), which includes emphysema, chronic bronchitis, and asthma. The ACSM recommends that all participants with pulmonary disease receive physician's clearance prior to participating in an exercise program. The body's need for oxygen intake and carbon dioxide removal is increased during exercise, so participants with pulmonary diseases must learn how to cope with diminished lung capacity and increased oxygen demands. Gas exchange impairments also create problems for the cardiovascular and muscular systems. 

Benefits of exercise

Benefits of exercise for participants with pulmonary disease include the following:

• Cardiovascular reconditioning 
• Desensitization to dyspnea (shortness of breath)
• Improved ventilatory efficiency
• Increased muscular strength and endurance
• Improved flexibility
• Improved body composition
• Better balance
• Enhanced body image
• Increased feelings of weel-being

Program considerations 

Intensity, duration, and frequency of programming for participants with pulmonary diseases are directly dictated by individual participant factors. Medications, the exercise environment, exercise tolerance at any given time, the need for breathing treatments or oxygen, fatigue level, and many other factors make exercise programming for this population a dynamic effort. Following are a few additional considerations for participants with pulmonary disease.

• Participants with COPD might feel better exercising at certain times of the day or shortly after they have taken their medication. Maximal limits of exercise are set as tolerated by symptoms.
• It is typically recommended that asthmatic exercisers take medication 10 minutes prior to exercise and carry an inhaler at all times. The participant should consult his or her physician.
• Asthma might develop during prolonged exercise. The threshold for producing asthma symptoms is typically around 75% of predicted max heart rate.
• The hydrostatic pressure of the water might make it more difficult for participants with lung disease to breathe when submerged. Ventilatory muscular fatigue is common because of the increased work of breathing. Time might be needed to strengthen the breathing muscles before starting a conditioning program. Participants might need to start in waist-deep water and work up to chest-deep water.
• The warmth and humidity in the aquatic environment might make it easier for some participants with lung disease to breathe.
• Participants might be sensitive to chemical fumes in the aquatic environment. Be aware of ventilation issues and help asthmatic exercisers recognize and control their triggers.
• Participants with pulmonary disease can exercise more comfortably and successfully when they are desensitized to dyspnea, fear, and other limiting symptoms.
• Improved coordination, balance, form, and technique will help to conserve energyand provide more oxygen to working muscles.

Recommended water temperature: A temperature range of 83 to 86 degrees F (28 to30 degrees C) is recommended for moderate to high intensity exercise. Water temperature should increase as intensity of exercise decreases.

Recommended tempo: Tempo needs to be self-paced.

Recommended water depth: Armpit depth can be used for participants who can tolerate the additional work for the breathing muscles. A shallower water depth might be needed initially until the participant adapts.

Recommended program formats: Program formats will vary depending on limitations and abilities. Some participants will be able to tolerate a cardiorespiratory format, and others might be capable of performing only basic toning and stretching exercises.